Pharmaceutical technology can turn a traditional drug, dexamethasone into a first-line ocular medicine. A global perspective and future trends

Villanueva, Javier Rodríguez; Villanueva, Laura Salanova; Navarro, Manuel Guzmán

doi:10.1016/j.ijpharm.2016.11.053

Cited by 62 publications

(38 citation statements)

References 52 publications

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“…Even though intravitreal injections are generally safe, the monthly and bimonthly requirements for these injections in long-term treatment may cause problems such as infection and reduced patient compliance [128][129][130][131][132]. For these reasons, intravitreal drug delivery systems are needed that will maintain therapeutic drug concentrations for an extended time, prolong the drug effect, and reduce the required number of applications [128,130,131,[133][134][135]. Obviously, the systems must also be safe and ideally they must be biodegradable, as biodegradable drug delivery systems do not require subsequent surgery to remove them from the eye [133].…”

Section: Intravitreal Administrationmentioning

confidence: 99%

Polysaccharides in Ocular Drug Delivery

et al. 2019

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Polysaccharides, such as cellulose, hyaluronic acid, alginic acid, and chitosan, as well as polysaccharide derivatives, have been successfully used to augment drug delivery in the treatment of ocular pathologies. The properties of polysaccharides can be extensively modified to optimize ocular drug formulations and to obtain biocompatible and biodegradable drugs with improved bioavailability and tailored pharmacological effects. This review discusses the available polysaccharide choices for overcoming the difficulties associated with ocular drug delivery, and it explores the reasons for the dependence between the physicochemical properties of polysaccharide-based drug carriers and their efficiency in different formulations and applications. Polysaccharides will continue to be of great interest to researchers endeavoring to develop ophthalmic drugs with improved effectiveness and safety.

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Section: Intravitreal Administrationmentioning

confidence: 99%

Polysaccharides in Ocular Drug Delivery

et al. 2019

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“…Similar to all glucocorticoids, DXM binds to the intracellular glucocorticoid receptor α after dissociation of the receptor from heat shock protein 90. 23 , 24 This promotes translocation of the complex to the nucleus where it acts as a transcription factor to induce the expression of genes with anti-inflammatory effects, such as lipocortin, IL-1 receptor antagonist, IL-10, and IκBα genes. 25 , 26 In addition, DXM inhibits upstream signaling through NF-κB and AP1 pathways, which prevents production of inflammatory cytokines (ie, TNF-α, IFN-γ, IL-6, etc.…”

Section: Mechanism Of Actionmentioning

confidence: 99%

“… 40 – 42 In contrast, the corneal endothelium contains leaky tight junctions that facilitate passage of DXM between the aqueous humor and stroma, and thus, increases its bioavailability at the target site. 24 The conjunctiva is another major barrier to drug penetration. This highly vascularized tissue has an abundance of capillaries and the absorption of drug into the conjunctival blood vessels allows significant drug loss into the systemic circulation.…”

Section: Topical Drug Deliverymentioning

confidence: 99%

Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy

Shah¹,

Conway²,

Peyman³

2018

OPTH

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Cataract surgery is one of the most commonly performed surgeries worldwide, with nearly 20 million cases annually. Appropriate prophylaxis after cataract surgery can contribute to a safe and quick visual recovery with high patient satisfaction. Despite being the current standard of care, the use of multiple postoperative eye drops can create a significant burden on these patients, contributing to documented and significant non-adherence to the postoperative regimen. Over the past 25 years, there have been a few studies analyzing the use of intracameral dexamethasone (DXM) in controlling inflammation following cataract surgery. This review explores various drug delivery approaches for managing intraocular inflammation after cataract surgery, documenting the strengths and weaknesses of these options and examining the role of intracameral DXM (among these other strategies) in controlling postoperative intraocular inflammation. Intracameral DXM has a particular advantage over topical steroids in possibly decreasing postoperative inflammatory symptoms and objective anterior cell and flare scores. Compared to topical steroids, there may be a slightly less theoretical risk of significant intraocular pressure spikes and systemic absorption. In addition, surveys indicate patients prefer an intraoperative intracameral injection over a self-administered postoperative eye drop regimen. However, there are several adverse effects associated with intracameral DXM delivery that are not seen with the noninvasive topical approach. Although it is unlikely that intracameral DXM will replace topical medications as the standard management for postoperative inflammation, it is seemingly another safe and effective strategy for controlling postoperative inflammation after routine cataract surgery.

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“…72, 73 While this glucocorticoid has been shown to effectively reduce inflammation following eye injury, it is also rapidly cleared from both chambers. 15 Recent studies by Yavuz et al and Soiberman et al have utilized hydroxyl terminated PAMAM dendrimers to sustain DEX delivery after subconjunctival injection.…”

Section: Injectable Formulationsmentioning

confidence: 99%

Dendrimers for ocular drug delivery

Lancina

Yang

2017

Can. J. Chem.

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Existing methods of administering ocular drugs are limited in either their safety or efficiency. Nanomedicine therapies have the potential to address this deficiency by creating vehicles that can control drug biodistribution. Dendrimers are synthetic polymeric nanoparticles with a unique highly organized branching structure. In recent years, promising results using dendrimer vehicles to deliver ocular drugs through different routes of administration have been reported. In this review, we briefly summarize these results with emphasis on the dendrimer modifications used to target different ocular structures.

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Pharmaceutical technology can turn a traditional drug, dexamethasone into a first-line ocular medicine. A global perspective and future trends

Cited by 62 publications

References 52 publications

Polysaccharides in Ocular Drug Delivery

Polysaccharides in Ocular Drug Delivery

Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy

Dendrimers for ocular drug delivery

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